靶点靶线体表描记法在CT引导经皮肺穿刺活检术中的应用

Application of target line surface tracing in CT-guided percutaneous lung biopsy

摘要:

目的 旨在探讨靶点靶线体表描记法在CT引导经皮肺穿刺活检术中的技术要点及应用价值。方法 选取2021年8月至2022年4月进行肺穿刺活检的病例152例，随机分为A组（77例，采用靶点靶线体表描记法穿刺）和B组（75例，常规穿刺法），比较2组首次进针成功率、CT扫描次数、诊断准确率、术后并发症及手术时间以评估2种手术方法效果。结果 2组均穿刺成功并取得标本，穿刺成功率均为100%。首次进针成功：A组64例，B组62例，2组间无统计学差异（χ^２=0.005，P=0.941）；CT扫描次数超标：A组18例，B组54例，2组间有统计学差异（χ^２=36.030，P<0.05）；诊断准确：A组70例，B组68例，2组间无统计学差异（χ^２=0.003，P=0.959）；咯血：A组12例，B组9例，2组间无统计学差异（χ^２=0.410，P=0.522）；气胸：A组10例，B组11例，2组间无统计学差异（χ^２=0.090，P=0.764）；手术时间：A组平均（19.88±4.47） min，B组平均（32.23±4.95） min，2组间有统计学差异（t检验，P<0.05）。结论 CT引导肺穿刺术中应用靶点靶线体表描记法简单易行，能准确指导CT引导肺穿刺术中穿刺角度的把握，减少术中CT扫描次数，值得在临床中推广。

Abstract:

Objective To investigate the key technical issues and application value of target line surface tracing in CT-guided percutaneous lung biopsy.Methods A total of 152 patients who underwent lung biopsy from August 2021 to April 2022 were enrolled and randomly divided into group A with 77 patients and group B with 75 patients. The efficacy of the two surgical methods was evaluated by comparing the two groups in terms of the success rate of first-time needle insertion，the number of CT scans，diagnostic accuracy，postoperative complications，and time of operation.Results Both groups A and B had successful puncture with specimens obtained，and the success rate of puncture was 100%. Successful first-time needle insertion was achieved for 64 patients in group A and 62 in group B，with no significant difference between the two groups（χ²=0.005， P=0.941）；18 patients in group A and 54 in group B had an excessive number of CT scans，with a significant difference between the two groups（χ²=36.030，P<0.05）；70 patients in group A and 68 in group B achieved an accurate diagnosis， with no significant difference between the two groups（χ²=0.003，P=0.959）. Hemoptysis was observed in 12 patients in group A and 9 patients in group B， with no significant difference between the two groups（χ²=0.410， P=0.522），and pneumothorax was observed in 10 patients in group A and 11 patients in group B， with no significant difference between the two groups（χ²=0.090，P=0.764）. The mean time of operation was （19.88±4.47） minutes in group A and （32.23±4.95） minutes in group B，and there was a significant difference between the two groups（t-test，P<0.05）.Conclusion The application of target line surface tracing in CT-guided lung puncture is simple and easy and can accurately guide the angle of puncture and reduce the number of CT scans during surgery，and therefore，it holds promise for clinical application.